Currently, gout in young people tends to increase, causing pain and affecting the daily life of the patient. So what is the cause of this condition, how to treat gout in young people? Along learn more about these issues through the article below.
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Gout in young people and what to know
Gout is a osteoarthritis that occurs when there is a disorder in the metabolism of purines, causing the amount of uric acid in the blood to rise. Normally, uric acid will be dissolved in the blood, excreted by the kidneys and excreted by the urinary tract. But when they increase too much, can not be eliminated to the outside, causing urate crystals to settle in the tissues and cause disease.
Previously, gout was considered a disease of men over 50 years old, now, the infected age is being rejuvenated. However, young people with gout often have a subjective attitude, assuming that the disease does not cause serious effects. As a result, they do not treat them early or do not adhere to the indications of treatment from their doctor, leading to more serious problems. So what causes gout in young people?
1. Causes of gout in young people
We all know gout is caused by an accumulation of uric acid in the tissues. Increased concentration of uric acid in the blood is divided into 3 groups of basic causes: congenital increase, primary cause, secondary cause. As follows:
Congenital increase:
People with HGPT enzyme deficiency from an early age often have unstable blood uric acid levels and lead to gout. This is a rare case, but when these people get sick it is often very severe, difficult to detect and also very difficult to cure.
Primary cause:
Usually related to genetics, genetics. Therefore, for those whose family has had gout before, the risk is much higher. The endogenous purine synthesis in their bodies is usually higher than normal. Therefore, the concentration of uric acid in the blood also increases.
Secondary cause:
This is considered the most common cause of gout in young people because it comes from external factors. Common secondary causes include:
- Eat too many foods containing many purines such as animal organs, red meat, mushrooms, fish …
- Use a lot of alcohol
- Suffering from hematological diseases such as bone marrow pain, polycythemia vera, neurosarcoma, lymphadenopathy … can stimulate the degeneration of endogenous purines thereby destroying many cells.
- Overweight, obesity
- Living environment is polluted
- Have had organ transplant surgery
- Using too many diuretics, aspirin, chemotherapy drugs, drugs that can weaken the immune system such as cyclosporine …
- Hypertension
- People who have had heart disease, atherosclerosis, diabetes mellitus, clogged blood vessels, high blood pressure, and infectious diseases.
- Abnormal kidney function …
2. Symptoms of gout
The urate salt crystals accumulate in the surrounding joints and tissue for about a year, and the disease will begin. Like other subjects, gout symptoms in young people often appeared suddenly at night. In a few cases, there are no early signs, symptoms are easy to appear in people who have had acute or chronic gout .
The main symptoms include:
- Joints hurt suddenly, intensely and swollen
- If touched, the joints will hurt more.
- Redness in the joint area
- The area around the joint becomes warmer.
These symptoms usually last for a few hours, for about 1-2 days. But for those who are already very sick, the pain can occur within weeks.
Gout in young people, if not treated properly, or taking drugs infrequently, the symptoms of the disease will become more serious. The patient may experience the following problems:
- Damage joints: The joints can be permanently damaged, leading to the risk of damaging joints and other bones.
- Tophi: This is a buildup of crystals under the skin. The common places to appear are the knees, around the toes, fingers, and ears.
- Kidney stones: If gout is not treated properly, uric acid crystals not only accumulate around joints, but can also accumulate in the kidneys, causing kidney stones.
Diagnosis and treatment of gout in young people
Gout is diagnosed and treated as follows:
1. Diagnosis
Since the symptoms of gout are often similar to other medical conditions, it is difficult to make an accurate diagnosis. First, the doctor will conduct a medical history and physical examination. After that, appoint the patient to conduct a subclinical examination and perform definitive diagnosis. As follows:
Laboratory testing:
- Proceeding to absorb joint fluid to find crystals of uric acid
- Ultrasound of the joints
- Joint X-ray
- Joint CT scanner
Diagnosis confirmed:
To accurately diagnose gout, definitive diagnostics will be indicated. One of the following criteria can be selected:
+) Bennet and Wood Standard (1968): Sensitivity 70%, specificity 82.7%
This is a diagnosis that is widely applied in our country because it is easy to remember and is suitable for testing conditions in Vietnam.
With this method, the patient has gout when crystals of sodium urate are found in the tophi nodules or in joint fluid. Or have at least 2 of the following:
- Have had or are having at least 2 painful swelling in 1 joint. These pains are characterized by sudden onset, severe pain that resolves within 2 weeks.
- Tophi appears.
- Have had or are experiencing painful swelling in the joints of the feet or big toe The pain has a sudden onset, severe pain, but completely resolves within 2 weeks.
- Have had or are responding well to colchocin (an analgesic, anti-inflammatory agent within 48 hours).
+) Standards of ILAR and Omeract (2000): Sensitivity 70%, specificity 78.8%
Gout is identified when: Urate crystals are found in synovial fluid, and or: There is a characteristic urate crystals in the tophi nodule when chemically tested or polarized, and or: Yes 6 Of a total of 12 clinical manifestations, the X-ray test was as follows:
- Occurrence more than 1 arthritis attack
- Progressive inflammation lasts up to 1 day.
- Redness in the joint area
- Arthritis in a joint
- Swollen and painful joints in the feet and toes
- Tophi is seen under the skin
- Arthritis of the foot, toe I on one side
- The affected joint area is asymmetric
- Unilateral ankle arthritis
- Uric acid in the blood increased at: Greater than or equal to 420 mmol / l for men, or greater than or equal to 360 mmol / l for women.
- Having cysts under the bone shell, X-ray showed bone defect
- The bacteria culture was negative
2. Treatment of gout in young people
The principles of treatment:
Methods are used to treat arthritis during acute gout attacks. At the same time, there are measures to prevent relapse, urate deposition in tissues. Prevention of complications through the treatment of hyperuricemia syndrome. The goal is to control blood uric acid levels below 360 mmo / l in patients with gout without tophi, less than 320 mmol (50 mg / l) for tophi gout.
Specific treatment measures:
+) Medical treatment:
The patient will be prescribed drugs:
- Anti-inflammatory drugs: Use during the onset of acute gout attacks to reduce inflammation.
- Medicines to reduce uric acid in the blood: It is indicated for chronic cases to prevent recurrence of acute gout attacks.
+) Surgical treatment:
The patient will be prescribed surgery to remove subcutaneous tophi in the following cases:
- Gout is accompanied by ulcer complications
- Tophi is superinfected
- Tophi is large in size, affecting mobility or for aesthetic reasons.
If performing surgery, patients need to use colchicine to avoid having acute gout attacks. At the same time, pain relievers, blood uric acid-lowering drugs will also be indicated.
+) Develop a reasonable diet – living for the patient:
- Do not eat foods containing high levels of purines such as animal organs, fish, shrimp, meat, crabs … Patients can eat eggs, fruits, meat, but not more than 150 grams / day.
- Should lose weight, exercise regularly
- Do not drink alcohol and other stimulants. Instead, drink plenty of fluids (about 2-4 liters per day).
- Do not use drugs that increase uric acid in the blood. Minimize stress, injury … to avoid factors that trigger gout attacks.
- Follow-up on time. This is really important, because follow-up will help monitor the progress of the disease as well as the health status.
How to prevent gout?
Previously, many people used to think that gout was a disease of the rich and often only encountered in the elderly. But now, anyone can get sick, especially the age of the disease is getting younger and younger. The cause of this condition mainly comes from the patient’s eating and living habits. Therefore, if you have a proper diet and activities, you will reduce the risk of this disease.
Here are some possible remedies:
- Do not eat too much food that easily increases uric acid in the blood such as shrimp, crab, crab, squid, animal organs, flipped duck eggs …
- Limit the use of spicy, hot, fatty foods, sweet foods, and animal fats.
- Limit the use of stimulants, tobacco.
- Should supplement the body of green vegetables, fruits in the daily menu. Especially anti-inflammatory foods, containing many vitamins and fiber such as: Broccoli, cauliflower, spinach, cabbage, grapefruit, apples, oranges, pears …
- Drink fruit juices regularly. It has the effect of stabilizing the concentration of uric acid, while enhancing the resistance.
- Keep weight at a stable level, if you are overweight, lose weight.
- Regular exercise and sports to improve your health.
- Do not eat too full or let your stomach too hungry.
- Drink plenty of water for better body cleansing.
- Do not overdo drugs, especially those that easily increase uric acid in the blood such as diuretics, aspirin.
Above is information you need to know about gout in young people. If not treated early, gout can deform bones and joints, reduce or permanently lose mobility. And yet, if the tophi particles under the skin are broken, the bacteria will easily penetrate the joints, causing inflammation and sepsis. In addition, it can cause other serious complications. Therefore, go to the doctor and treat the disease early when abnormal manifestations appear to protect your health.
